In the clinic where I work, I met a patient the other day whom I might not have 20 years ago.
He was from Uganda. Recently, he had moved to my small university town a few hours outside of Toronto. He was eager and bright. As we spoke, I was struck by how coolly he handled himself in the face of a great adversity. He told me that during an emergency medical procedure, in a rural village where he was doing fieldwork, he contracted HIV. Doctors gave him medicine — antiretrovirals that suppressed the virus for years. Sitting across from me, he said that he hoped we could extend his supply.
What made our interaction possible, I later thought, was a remarkable program called PEPFAR. In the early 2000s, therapies for HIV were widely available in Western countries but scarce in the developing world — in places like Botswana, one-third of the adult population was infected. Millions of people were dying from AIDS. In response, George W. Bush created the President’s Emergency Plan for AIDS Relief — PEPFAR, for short. Over time, it would blossom into the largest global health initiative ever dedicated to a single disease.
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