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One Toke Over The Line: University of Denver’s Korbel School of International Studies To Grant George W. Bush an International Service Award: Part Five of an Open Series

August 13, 2013
Africa - Ethnic Groups

Africa – Ethnic Groups

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Part One of the series

Part Two of the series

Part Three of the series

Part Four of the series

Part Five also appears at Counterpunch

Part Six of the series

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1.

Bush’s Contribution to Fighting AIDS in Africa: A Freddy Krueger Mask?

The thin thread – the pretext – for offering George W. Bush what  was originally entitled an “Improving The Human Condition Award”, now referred to as `a Global Service’ award (by the University of Denver) – is his supposed work to fight AIDs in Africa.

By emphasizing Bush’s Africa anti-AIDS campaign, most recent explanation for this award, the Korbel School is not doing anything original.  A look at the mainstream American media over the past months – starting in the early Spring – suggests nothing short of a coordinated media campaign to reshape Bush’s image. But in many ways, this “re-branding George W. Bush campaign” is  worse than trying to put lipstick on a pig—it’s more like putting a Freddy Krueger mask on a pig. It makes the pig look worse.

It has included virtually the entire news media, from newsprint to television and tended to sing the same song: that Bush made a major contribution to fighting AIDS in Africa through PERFAR, an initiative begun in early 2003 – in fact, just before the Bush Administration launched its war against Iraq. Add glowing comments from the likes of Bono, Elton John and Matt Damon (his `I would kiss George W. Bush on the mouth for his AIDS work‘ tops the list) to spit shine the image. Bush’s evangelical supporters – a key element to his constituency – chipped in as well. What stands out about this campaign – check any source – is the nearly complete absence of any remarks critical of the PERFAR program.

This Bush image remake culminated in the opening of the Bush Presidential Library in Texas where the former President, Christian fundamentist and cocaine sniffer got bipartisan kudos from Republicans and Democrats alike. It is not only the University of Denver’s administration that is touting Bush’s supposed contribution to countering AIDS in Africa. As one might suspect given Bush’s record on “improving the human condition”, there is much less here than meets the eye.

In many ways, Bush’s AIDS work is more an example of how not to conduct a foreign aid program, than how to do it. Take away the AIDS initiative and all that is left is the wars in Afghanistan, Iraq, the use of torture, intensification of secret special forces operations, helping to promote the collapse of the US and global economies.

The U.S. governmental program to fight HIV/AIDS is formally known as the President’s Emergency Plan For AIDS Relief (PEPFAR). From the outset, PEPFAR has been run out of the Department of State’s Office of U.S. Global AIDS Coordinator (OGAC).  The project works through many other U.S. government agencies (US AID, etc). PEPFAR, according to its own reports, has given anti-retroviral drugs – according to 2013 GAO report to 5.1 million people, more than half of these in low or middle income countries, many of them in Africa. In recent years PEPFAR has shifted emphasis to training in-country specialists to take over the programs. The program has somewhat expanded under Obama.

But what sounds good in the press is not necessarily so in fact.

At best, the results have been mixed. A great deal of money has been spent on the program since its inception with questionable, limited – often exaggerated results and few serious follow up studies. From the outset the program has been plagued with criticisms – some of them serious; do the critiques of the program outweigh the benefits? At the same time there is another issue: how much really has George W. Bush contributed to the shaping and the implementation of the program, if at all?

If PEPFAR has some serious shortcomings, still, its accomplishments cannot be entirely written off. It is almost as if some good has come from the program in spite of itself.  As a recent GAO report on PEPFAR notes: “our recent reports have concluded that PEPFAR has helped partner countries expand treatment programs and increase program efficiency and effectiveness” The same report hints at some of PEPFAR’s problems: “However we found that the OGAC has not yet established a common set of indicators to monitor the results of PEPFAR’s efforts to improve the quality of treatment programs.” (p.14) “Also problems of in-country inventory controls and record keeping’ – ie – waste, theft, corruption.

Some of the success is due to the program’s change in policy, its ability to purchase generic ARV drugs. When Bush was in office, PEPFAR was little more than yet another boom for U.S. pharmaceuticals as the program required that the drugs be purchased from the pharmaceuticals holding patents, It was the shift to generics, encouraged according to some sources by Bill Clinton, has led to a significant extension of the program and $1 billion savings over a five year period. As a result, the cost per patient has gone dropped some 400% from 2005-2011 and many more people have been treated.

Among the more serious criticisms of PEPFAR is the way the program is implemented in Uganda. At the heart of the program is what is referred to as the ABC approach, an acronym for `abstention, be faithful, use a condom’ – a touching, Christian fundamentalist inspired, but almost entirely irrelevant way of treating AIDS. The program is not run out of the United Nations nor organizations like the World Health Organization, but is run bilaterally between the United States and the target nations involved.

PEPFAR there is a typical `top down’ bureaucratic affair with very little interaction with “folks on the ground”, similar in many ways to many World Bank/IMF structural adjustment programs – a lot of sound and fury signifying much less than asserted. As the ABC approach glaringly suggests, PEPFAR is infused with Christian fundamentalist values.  In line with their skewed thinking, the program promotes `abstention’, prostitutes and homosexuals are excluded from treatment. Emphasizing abstention tends to focus on individual behavior modification for prevention, – as opposed to structural change, or some kind of hybrid approach or an approach which focuses on prevention.

By excluding those more likely to be affected by HIV/AIDS, PEPFAR is shooting itself in the foot.  The results have been – almost predictably – uneven. If HIV/AIDS levels in Uganda did dip in the early years of the program, their levels are once again on the rise. While some groups see (significantly) falling rates of HIV/AIDS prevalence, other groups see rates rising or unchanged (e.g. married women, LGBT community). In a similar vein, there is no real evidence that the credit for declining HIV prevalence where it exists, is as a result of the Bush program.

PEPFAR has also resulted in a number of unintended consequences: the marginalization of groups at high risk for HIV/AIDS (LGBT, prostitutes, IV drug users, etc.); the promulgation of misunderstandings about HIV transmission, prevention and safe sex (condoms); the promulgation of misunderstandings about the causes of HIV/AIDS epidemic (structures and flows matter too! e.g. gender hierarchies, class hierarchies, economic change, migratory flows).

Even if we examine only the most narrow issue at play in the context of the Korbel Award—the Bush record on HIV/AIDS prevention and treatment—Bush’s record of “global service” falls short. In Uganda, the ABC prevention program spread US power and influence, reinforced unjust social divisions, propagated misinformation, all the while actually causing HIV/AIDS infection rates to rise in some cases.  Even where HIV/AIDS rates have fallen (for some populations, very considerably), the role of the Bush program in this fall is heavily disputed.

2.

From the Peace Corps in the 1960s to PEPFAR Today – A Never-ending Effort to Reshape The U.S. Foreign Policy Image…

U.S. foreign policy has often had more than one face. For example, in the early 1960s, Presidents Kennedy and Johnson launched the steamroller wars in Indochina, conducted aggressive interventions and C.I.A.-like coups in dozens of Third World countries (Congo, Dominican Republic, Iraq, Cuba, much of Latin America – just to name a few). At the same time that the Kennedy Administration was putting in motion what would become a half a century of counter-insurgency into Third World affairs, it also created the Peace Corps!

It is a mistake to underestimate the public relations importance of the Peace Corps (or now PEPFAR), which soften an otherwise militaristic and essentially greedy reality of U.S. foreign policy. In both the case of the Peace Corps and PEPFAR, the public relations aspect of the campaign has been as important – if not more important – as the actual results. It is not that Peace Corps `did nothing’ to help the countries where its volunteers were sent, but its overall record in terms of aiding development is spotty at best. Furthermore, one notes how few serious, rigorous studies have been done to evaluate Peace Corps’ contribution, effectiveness or lack thereof.

If the Kennedy and Johnson Administrations were dropping napalm and phosphorous bombs all over Vietnam, putting people in tiger cages and executing tens of thousands there based up a `profiling’ program known as the Phoenix Program, in Tunisia (and elsewhere) Peace Corps architects were designing civic centers and reconstructing mosques, training daycare center directors and teaching English in high schools and universities at the same time. Building bridges in one part of the world paralleled blowing them up elsewhere.

The Bush Administration’s policy of `combatting HIV/AIDS’ in the periphery of the global economy while destroying Iraq and Afghanistan is the more recent example of the same policy a half century on. Launching PEPFAR at the same time as he was launching Cruise missiles at Iraqi power stations, bridges and hospitals provided Bush with a veil of respectability that would later come in handy. PEPFAR began in early 2003, right around the time that the Bush Administration launched its war in Iraq which led to the overthrow of Saddam Hussein and the implosion of that country. What was probably the most economically and socially advanced country in the Arab world was reduced to rubble within a decade.

If U.S. forces were bombing bridges in Baghdad and Basra, the U.S. State Department was giving out anti-HIV vaccinations in Uganda and preaching sexual abstinence to locals there. If one counts the civilian casualties from the Iraq war alone, which government U.S. statisticians are careful not to do, the deaths inflicted by the conflict by some counts are more than one million. Another four million out of a population of 22 million were made refugees either within the country or abroad. The casualties inflicted on Afghanistan are similarly tragic. No amount of embellishing – if not inventing – George Bush’s supposed contribution to combating HIV/AIDS can undo that damage. The smudge cannot be erased.

15 Comments leave one →
  1. JIM permalink
    August 14, 2013 12:14 am

    BONO is some marketer for Louis Vuitton designer outfits, as he struts off his private plane in Africa. Never mind, that Ireland became a tax avoidance haven for American corporations, like Apple and assorted drug companies, and a big section of the fortune 500 companies on the NY Stock Exchange. Never mind that BAE, the big British Arms company gets special mention, when one considers Frontman Bono.
    But, if any can explain how George Bush took the cost of aids prevention virus shots from over $ 300 per shot, down to 20 cents, please document that with specifics,(if any out there WWW, can), it seems some professor at the University of Utah, is pandering to some nitch on the Post Presidency, of American Presidents, and does some wild spin on George Bush.
    It just seems absurd, but I prefer River Dancing gigs, and can pass on some of BONO’S Bloody Sunday renditions. “Bloody Sunday” was a common thing with what happened in the Mid East from his buddy Paul Wolfiwitz, but of course, his reputed and well documented tax avoidance antics puts BONO in a class of the King of hypocrites, but drug companies(who are really American), who have their tax avoidance papers all on file in Ireland, must dig the guy.

    So, much for the Chinese who underwrote the U S deficit, linked to those $ 30 billion in African aid doles, but, why quibble, with how good a FRONTMAN BONO is for the despots of the world, Cheney, Bush, and Club.

  2. Jim permalink
    August 14, 2013 9:34 am

    U2 of course was a spy plane
    that flew over Russian during the
    Cold War.
    Not that Bono named his band
    after a military aircraft to bring up
    Images of Iron Curtains, and
    Berlin Walls, but he could just as well named his jolly chaps, the Robert Maxwell rovers. Don’t forget, that the
    Ex Chairman of the Joint Chief of Staff( USA) noted that America’s biggest national security threat are massive deficits. But, What Bono represents
    is one who can be used by Bush
    as a diversion from what were the biggest foreign policy blunders in
    American history in the Mideast
    so he is just a Lil harping tool of
    the Bush P R machine, that has
    surfaced just as pony girl Liz
    Cheney is ridding high in her Teton
    saddle in Wyoming .

  3. John Kane permalink
    August 16, 2013 5:56 am

    Rob — agree and disagree — on both points (effectiveness of PEPFAR and simultaneous combination of peace and war efforts) you make the fundamental error of making the perfect the enemy of the good. Surely most of your readers abhor the war policies of 60s and 2000s and can agree that the peace efforts (PC and PEPFAR) were used for PR purposes. But those facts don’t negate the limited goods of PC and PEPFAR. Similarly on PEPFAR, you’re undoubtedly right to criticize its exclusion of “objectionable” people (prostitutes, drug users, etc.) — something I hadn’t known — but why combine that with a simplistic critique of ABC? My PC son working in South Africa had no problem working with high-school kids to produce skits for middle-schoolers based on ABC and simultaneously working for inclusion of gays, etc., and for structural reform (e.g., doing away with homelands which separated men from families…). Why make simplistic rhetorical points which mar your important arguments. John

    • August 16, 2013 6:01 am

      Hi John,

      Thanks for commenting. From where I am sitting, the ABC formula is a part of the problem, not the solution. It is, in a word, silly (besides being culturally biased) and ultimately undermines much of the good work that is being done to fight HIV/AIDS in Africa. Interesting the work your son is doing in S.A. – regards, Rob

      • John Kane permalink
        August 16, 2013 6:07 am

        I agree to disagree — his work was in the late 90s. John

  4. Phil Jones permalink
    August 16, 2013 6:18 am

    Couldn’t agree more with this essay about Bush II’s real legacy and the depressing US habit of using one hand to offer candy and the other hand to shoot a gun..

  5. August 16, 2013 9:37 am

    I think the amount of $$ committed to Iraq vs. to AIDS prevention is worth a look. Just as the amount of dollars committed to military aid in general vs. humanitarian and economic aid passes judgment not just upon Bush but upon the whole US enterprise. Bush and his “advisors” of course were more egregious in their actions — geometrically — and their divestment of US commitment to a world of law and order, something that might actually have led to improvement in the human condition.

  6. August 16, 2013 10:40 am

    from a friend from Mali by email:

    “This is again a very interesting but controversial article. As you know many people in Africa believe that President Bush has been very helpful to african countries through the MCC, the Anti-AIDS program, anti-malaria program, etc. But as you its all about geopolitics and interests of nations. I really like your article. Thank you for sharing”

  7. August 16, 2013 10:44 am

    this from a friend from my Peace Corps Tunisia days (1966-68)…

    “as always, I agree with your ideas and love your style. You manage to address the realities and complexity of the issue without boring the reader and this seldom happens with political writing.

    One small but important point —– when you write about Peace Corps Tunisia, I wish you’d also mention that we were managing kindergartens throughout the country and training Tunisian kindergarten teachers in modern methods of early childhood education. This was a huge effort in so many villages and towns where there were no architects or English teachers. Some of us have gone back to our villages over the years and been recognized instantly and welcomed lavishly by our former students!”

  8. October 13, 2014 2:46 am

    Very good post! We are linking to this great article on our website.
    Keep up the good writing.

Trackbacks

  1. One Toke Over The Line: University of Denver’s Korbel School of International Studies To Grant George W. Bush an International Service Award: Part Four of an Open Series | Rob Prince's Blog
  2. One Toke Over The Line: University of Denver’s Korbel School of International Studies To Grant George. W. Bush An International Service Award: Part Three of an Open Ended Series | Rob Prince's Blog
  3. One Toke Over The Line: University of Denver’s Korbel School of International Studies to grant George W. Bush with its “Improving The Human Condition Award” – Part One (of an open-ended series) | Rob Prince's Blog
  4. One Toke Over The Line: University of Denver’s Korbel School of International Studies To Grant George W. Bush an `International Service’ Award (Part Two of an open ended series) | Rob Prince's Blog
  5. One Toke Over The Line: University of Denver’s Korbel School of International Studies To Grant George W. Bush an International Service Award: Part Six of an Open Series | Rob Prince's Blog

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