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Abstract

While former President George W. Bush's historical legacy is still being hotly debated, a clear bright spot is often overlooked. The President's Emergency Plan for AIDS Relief (PEPFAR) paid for antiretroviral medications for 1.4 million patients in Africa and the Caribbean compared to only 50,000 before the program. The program is far from perfect. An important criticism of PEPFAR is that the program is too restrictive. For example, one third of the money for prevention must go to abstinence only sexual education. The harm that is done to women and children by suggesting that they have the autonomy to insist on abstinence is clearly demonstrated by the high rates of HIV in these populations. True prevention will only be possible when the situation of women is improved and they are empowered to make decisions in their reproductive lives. Sadly, politics and religion are preventing Bush's "legacy” from having the impact that it otherwise could have had.

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