When the Bush administration inaugurated the program in 2003, fewer than 50,000 HIV-infected people on the African continent were receiving the antire*troviral drugs that keep the virus in check and halt the progression toward full-blown AIDS. By the time Bush left office, the number had increased to nearly 2 million. Today, the United States is directly supporting antiretroviral treatment for more than 4 million men, women and children worldwide, primarily in Africa.
This is an amazing accomplishment, especially because it wasn’t supposed to be possible.
Before PEPFAR, the conventional wisdom was that the drug-treatment regimens that were saving lives in developed countries would not work in Africa. Poor, uneducated people in communities lacking even the most basic infrastructure could not be expected to take the right pill at the right time every day. When the drugs are taken haphazardly, the virus mutates and becomes resistant. Therefore, this reasoning went, trying to administer antiretroviral treatment in poor African countries might actually be worse than doing nothing at all.
The Bush administration rejected these arguments, which turned out to be categorically wrong.