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By W. Gardner Selby December 16, 2010

President Bush says the United States doubled its commitment to fighting AIDS abroad in his first 17 months in office

President George W. Bush devotes a chapter of his memoir, Decision Points, to his interest in stopping AIDS abroad.

"When I took office, the United States was spending a little over $500 million a year to fight global AIDS," Bush writes. "That was more than any other country. Yet it was paltry compared with the scope of the pandemic." In May 2001, he writes, he endorsed the creation of a Global Fund to Fight HIV/AIDS, Tuberculosis and Malaria, making an initial U.S. pledge of $200 million, an amount increased to $500 million by early 2002. And in June 2002, he writes, he announced the International Mother and Child HIV Prevention Initiative.

"In 17 months," Bush said, "we had doubled America's commitment to fighting global AIDS."

By the time Bush completed his second term, in early 2009, such annual U.S. spending exceeded $5 billion, according to a breakdown posted online in February 2010 by the Kaiser Family Foundation.

But we wanted the back story. We started from an October 2009 PolitiFact inquiry, per a statement by U2's Bono, who credited Bush with tripling U.S. spending against AIDS in Africa. In 2008, the United States accounted for more than half (51.3 percent) of all the the global AIDs relief disbursed by governments around the world, according to an analysis by the Kaiser Family Foundation and UNAIDS. When adjusted for the relative size of the countries' economies, the United States ranked fourth highest, considerably higher than most European countries. The only ones that spent more proportionately were the Netherlands, United Kingdom and Bono's homeland, Ireland.

Kaiser spokesman Craig Palosky passed along a June 2004 report, "Analysis of aid in support of HIV/AIDS control, 2000-2002," whose authors include a program run by the United Nations. A table in the report shows the United States donated the most money to the AIDS fight in 2000, accounting for $329 million in such funding. The United Kingdom ranked a distant second, at $117 million.

In 2003, Bush initiated a $15 billion plan to address global AIDS relief, mostly for countries in Africa where the AIDS epidemic is staggering. And then in 2008, Congress — Democrats and Republicans alike — more than tripled the HIV/AIDS relief budget to $48 billion over five years.

We asked Eric Lief, a former senior advisor with the U.N. Joint Program on HIV/AIDS, to analyze Bush's statement about funding. (Lief now works for the Henry L. Stimson Center, a non-partisan public policy institute.) Via e-mail, he said: "The Bush administration showed real leadership on global HIV/AIDS. U.S. funding grew exponentially during the eight Bush years. But global funding is still far short of anything close to global need."

For particulars, Lief pointed us to a December 2006 Congressional Research Service report, "Trends in U.S. Global AIDS Spending: FY2000-FY2007." In fiscal 2000, the year before Bush was sworn in as president, annual U.S. spending on global HIV/AIDS assistance and to combat TB and malaria totaled $236.1 million, the report says. It totaled $564.5 million in fiscal 2001 and a little more than $1 billion in fiscal 2002. Subtracting out what Lief told us was the share of funding focused on battling TB and malaria, we estimated AIDS-specific funding at $518 million for fiscal 2001 and $930 million the year after--amounting to an increase of about 80 percent.

Finally, we heard back from David Drake, a representative of Bush's publisher, the Crown Publishing Group, after asking him for evidence behind Bush's statement. Drake said in an e-mail that by the end of June 2002, Bush had committed $500 million to the Global Fund and another $500 million to the International Mother and Child HIV Prevention Initiative.

A former Bush adviser, Jay Lekfowitz, writes in a January 2009 article in Commentary magazine that the initiative was intended to increase the availability of preventive care, including drug treatments, and to devise delivery systems that would reach pregnant women and newborn children in two Caribbean nations and eight African ones (with four to be added later).

Drake said Bush announced the second $500 million on June 19, 2002, just before the end of his 17th month as president. He was sworn in Jan. 20, 2001.

We rate Bush's statement True.

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Our Sources

Commentary, Jay P. Lefkowitz, "AIDS and the President--An Inside Account," January 2009 (accessed Dec. 14, 2010)

Congressional Research Service, report, "Trends in U.S. Global AIDS Spending: FY2000-FY2007," Dec. 26, 2006 (fetched Dec. 13, 2010)

E-mail, response to PolitiFact Texas, David Drake, senior vice president, executive director of publicity, The Crown Publishing Group, Dec. 14, 2010

E-mail (excerpted), response to PolitiFact Texas, Eric Lief, senior associate, The Henry L. Stimson Center, Washington, Dec. 13, 2010

Kaiser Family Foundation, federal funding fact sheet, "HIV/AIDS Policy," February 2010 (fetched Dec. 14, 2010)

PolitiFact, Truth-O-Meter article, "Bono claims U.S. gives about half the aid as European countries, percentage-wise," Oct. 30, 2009 (accessed Dec. 9, 2010)

Organisation for Economic Co-operation and Development and Joint United Nations Programme on HIV/AIDS, "Analysis of aid in support of HIV/AIDS control, 2000-2002," June 2004 (received Dec. 15, 2010)

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President Bush says the United States doubled its commitment to fighting AIDS abroad in his first 17 months in office

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