A good fortune for one man, means less for some

[Uboat509]

Agree that the AIDS work is less about saving Africans than about Americans feeling good about themselves...

I would have to disagree with the second part of your statement there. That is an awful lot of money to feel good about ourselves. That kind of money has an ulterior motive attached to it. Someone more cynical than me might suspect an attempt by a Republican president to curry favor with centrist voters but I believe that it is more about trying to gain some control of the narrative in Africa. China is increasingly visible in Africa, often at our expense. Combating AIDS is a fairly low risk investment to rebuild our political capital in Africa. Compared to economic development or conflict resolution it is relatively straight forward and uncontroversial with little chance that we will find ourselves on the wrong side of an issue. Whether we are getting a good return on our investment is debatable but, based on my experience in Africa, we are at least getting some return.

As to the question of whether combating AIDS is worsening things by increasing the demand for limited resources, I would have to say no. I would even say that it is probably reducing it. More and more countries are lowering population growth rates to the "replacement" rate of about 2.1 births. It is paradoxically the poorest states that have the highest fertility rates. HIV/AIDS has been hypothesized to have contributed directly to higher fertility rates as a means to counterbalance the high infant mortality rates. It is not, by far, the only or even the greatest cause of higher fertility rates in poor countries but it is a significant one and lowering the rate of infection will have a positive effect on fertility both directly as infant mortality rates secondary to HIV/AIDS fall and indirectly as the reduction or eradication of infection in a given region will likely have some positive effects on prosperity.

[Dayuhan]

I would have to disagree with the second part of your statement there. That is an awful lot of money to feel good about ourselves.

Why do you think that the money we spend on AIDS gets so much more attention than, say, money spent on controlling malaria? Is that not because AIDS is an issue and a problem with greater resonance for Americans?

That kind of money has an ulterior motive attached to it. Someone more cynical than me might suspect an attempt by a Republican president to curry favor with centrist voters but I believe that it is more about trying to gain some control of the narrative in Africa. China is increasingly visible in Africa, often at our expense. Combating AIDS is a fairly low risk investment to rebuild our political capital in Africa. Compared to economic development or conflict resolution it is relatively straight forward and uncontroversial with little chance that we will find ourselves on the wrong side of an issue. Whether we are getting a good return on our investment is debatable but, based on my experience in Africa, we are at least getting some return.

If that's the goal I suspect we'll be disappointed. Aid of any sort will never bring the kind of influence or favor that investment brings, and I don't think anything we do about AIDS will give us real political capital in Africa or "gain some control of the narrative in Africa".