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No Good Deed Goes Unpunished

The Unintended Consequences of Washington's HIV/AIDS Programs

Courtesy Reuters

The George W. Bush administration increased annual U.S. assistance to Africa almost sixfold, from $1.3 billion in fiscal year 2001 to $7.3 billion in fiscal year 2009. One-time debt forgiveness and emergency humanitarian assistance contributed to this increase, but it was primarily driven by the President's Emergency Plan for AIDS Relief (PEPFAR), the United States' single largest continuing commitment to Africa. PEPFAR, which was originally expected to disburse some $15 billion over its first five years, actually spent $25 billion between 2003 and 2008. The program also kick-started a sharp increase in AIDS-related assistance worldwide and laid the foundation for the G-8's announcement, in 2005, that it would provide all those infected with HIV with access to life-saving antiretroviral (ARV) treatment.

This commitment will become staggeringly large. There are currently just over 33 million people infected with HIV, more than 22 million of whom are in sub-Saharan Africa. In 1998, only a few hundred thousand people with the virus received

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