On the train this morning I thought back to a grad school lunch I attended long ago with Randy Shilts. He noted that he would be out for coffee with someone, notice a blotch on the man's forehead, and then quietly register that yet another friend would probably be dead in six months. Shilts died not long after that, one of almost 600,000 Americans who have died of AIDS.
You won't hear this from me every day—virtually any day, ever. I hope President Obama, Harry Reid, and John Boehner read George W. Bush's op-ed this morning in Washington Post. In fifty years, people will have even lower regard for the Bush presidency than they do today. PEPFAR will be one shining exception to that judgment. He believed in it, listened to people, mobilized a coalition, found the money, made it happen. It was flawed in many ways, but the guy deserves his due.
I will always wonder whether Bush could have achieved a more humane and successful presidency, were it not for 9/11 and what accompanied it. Whatever there might have been to compassionate conservatism was cut short by both the loosening of political constraints and the incredible psychological pressures associated with the global war on terrorism and the wars. PEPFAR was the one large exception.
The Obama administration hasn't backslid on AIDS. They have good people, good policies. They talk sensibly and humanely about HIV prevention. They are fixing the domestic public health infrastructure, which Bush's people really screwed up. As always, they don't have enough money to really do what must be done. People will look back on this time and say: We should have done more.
I shake my head when purported deficit concerns lead our society to under-fund the national and global fight against AIDS, maternal and child health, education, and development. Is there any better illustration of how stupidly we think about our future?
Harold Pollack is the Helen Ross Professor of Social Service Administration at the University of Chicago.