Bush Has Quietly Tripled Aid to Africa

"I think there are two reinforcing trends here. One of them is the upside of foreign policy moralism," said Michael J. Gerson, a former Bush aide who was a persistent and persuasive advocate for Africa. "Another one is the growing strategic significance of Africa: the conflict with radical Islam; the problem of failed states and terrorism; and the growing importance of Africa on the resource side: oil."

Some advocates suspect that the Bush administration's interest in Africa is motivated more by business ambitions than altruism. Grants made by the Millennium Challenge Corp., a foreign aid program developed by Bush with the aim of rewarding poor countries that practice good governance, are also partially predicated on whether countries have open markets that allow widespread foreign investment.

"I know a lot of activist groups who believe that the president's stated commitment to Africa is, at best, a play on words," said Nii Akuetteh, executive director of Africa Action, a Washington-based advocacy organization. "First of all, much of the aid is emergency food or medical aid, rather than true development assistance. Then there are conditions that are attached where the emphasis is more on countries that open up their markets so American companies can go in and privatize things like water and electrical service or have access to certain resources."

Bush launched his $1.2 billion malaria initiative in June 2005 with the goal of reducing malaria-related deaths in 15 African countries by 50 percent. The disease kills more than 1 million people a year, most of them African children under age 5.

The malaria program complements the president's largest global health initiative, the $15 billion, five-year plan known as the President's Emergency Plan for AIDS Relief (PEPFAR). Under the program, about 800,000 Africans are receiving drugs that enable them to live longer with the disease and help to prevent mother-to-child transmission of the virus.

"We launched one of the most important initiatives in American history, as far as I'm concerned, and that is the Emergency Plan for AIDS Relief," Bush said at a recent conference on malaria.

PEPFAR, which often funds programs through religious organizations, has come under criticism for promoting faith-based ideology over science, emphasizing abstinence programs and giving inaccurate information about the effectiveness of condoms in preventing HIV transmission. Payne says such concerns have been allayed in recent years, and he and others credit PEPFAR with saving hundreds of thousands of lives.

The Bush administration's efforts in Africa have dovetailed with a rise in aid to Africa from private groups, including the Bill and Melinda Gates Foundation, as well as loan forgiveness from organizations such as the World Bank and stepped-up assistance from other countries, including Britain and France.

"I think [increasing aid to Africa] will be one of the things the president is most proud of when he leaves office," Gerson said. "It doesn't fit the preconception, the caricature that the president somehow has a preference for using the blunt instruments of force in international affairs when in fact on a variety of topics, the president has been a root-cause thinker in an unexpected way."