I've gotten into some Twitter Debates™ over George W Bush's legacy and I'm getting tired of repeating myself, so here's a quick thread on why Bush Jr's administration had some very bright moments that deserve copious praise. Specifically, moments related to global health aid.

Health aid to the developing world isn’t the most sensational part of government spending, but it is arguably the most impactful, particularly when done well. And Bush delivered among the most impactful health aid programs of all time: PEPFAR
https://en.wikipedia.org/wiki/President%27s_Emergency_Plan_for_AIDS_Relief

It's difficult to overstate how bad the HIV/AIDS pandemic was in the late '90s/early '00s. More than a million people dying each year, overwhelmingly in the world’s poorest countries, kept poor in part due to the extreme burden of disease their populations suffered.

See that big drop in infections and deaths since the mid ‘00s? That’s when global health efforts really started getting their shit together, in no small part thanks to PEPFAR. It wasn't just the treatments donated, but the expertise and logistics that helped local teams work.

For a few billion dollars - peanuts by US federal budget standards - the program has saved tens of millions of people from an agonising death, averting untold suffering and facilitating a host of positive knock-on effects. https://www.nejm.org/doi/full/10.1056/NEJMp1714773

No large undertaking - good or bad - can be solely claimed by any single person. But PEPFAR wasn’t merely rubber-stamped by POTUS. Since before his election, Bush showed an interest in global health and personally made it a major (if unsung) focus of his administration.

He expended significant political capital to save lives from neglected diseases in a way that no other sitting president has. Others had ample opportunity to help, but they all found other topics to be more demanding of their attention. https://www.nytimes.com/2008/01/05/washington/05aids.html

Criticise Bush by all means - the Iraq war, climate inaction, mass surveillance, the list of his crimes and blunders goes on. But please don’t downplay the importance of aid initiatives like PEPFAR or mislead about Bush’s role in it.

Now more than ever, it’s clear that global health and biosecurity should be a top priority of our elected leaders and they deserve to be lauded when they make the right choice and save millions of lives as a result.