The subsidizing of expensive medications (the biggest part of our AIDS-relief effort, though not all of it) in fact has long-term consequences more likely to be negative than positive. The high incidence of AIDS in sub-Saharan Africa is caused by customary practices there. What is needed is for people to change those customary practices. Instead, at a cost of billions to the U.S. taxpayer, we have made it possible for Africans to continue in their unhealthy, disease-spreading habits.
Perhaps the future of sub-Saharan Africa would be brighter if the people of that place changed some of their customs; but now, thanks to us, they don’t have to.
Here are a few facts that undermine Derbyshire’s case: (a) Africans have fewer sex partners on average over a lifetime than do Americans; (b) 22 countries in Africa have had a greater than 25 percent decline in infections in the past 10 years (for South African and Namibian youth, the figure is 50 percent in five years); and (c) America’s efforts are helping to create a remarkable shifts in how, in Africa, boys view girls — reflected in a decline of more than 50 percent in sexual partners among boys.
So Derbyshire’s argument that our AIDS efforts are “more likely to be negative than positive” because they will continue to subsidize and encourage “unhealthy, disease-spreading habits” is not only wrong but the opposite of reality.
There is more. Derbyshire’s view might best be expressed as “the Africans had an AIDS death sentence coming to them.” But in Africa, gender violence and abuse is involved in the first sexual encounter up to 85 percent of time. And where President Bush’s PEPFAR initiative has been particularly effective is in slowing the transmission of the disease from mothers to children. Perhaps Derbyshire can explain to us how exactly infants are complicit in their AIDS affliction. Or maybe he doesn’t much care if they are.
Let’s now turn to Derbyshire’s characterization that America is becoming the “welfare provider of last resort to all the world’s several billion people”: he is more than a decade behind in his understanding of overseas-development policy.
President Bush’s policies were animated by the belief that the way to save lives was to rely on the principle of accountability. That is what was transformational about Bush’s development effort. He rejected handing out money with no strings attached in favor of tying expenditures to reform and results. And it has had huge radiating effects. When PEPFAR was started, America was criticized by others for setting goals. Now the mantra around the world is “results-based development.” Yet Derbyshire seems to know nothing about any of this. That isn’t necessarily a problem — unless, of course, he decides to write on the topic.
Beyond that, though, the notion that AIDS relief in Africa is AFDC on a global scale is silly. We are not talking about providing food stamps to able-bodied adults or subsidizing illegitimacy; we’re talking about saving the lives of millions of innocent people and taking steps to keep human societies from collapsing. Private charity clearly wasn’t enough.
On the matter of Derbyshire’s claim that AIDS relief in Africa is unconnected to our national interest: al-Qaeda is actively trying to establish a greater presence in nations like Tanzania, Kenya, and Nigeria, which have become major ideological battlegrounds. And mass disease and death, poverty and hopelessness, make the rise of radicalism more, not less, likely. (Because of AIDS, in some countries nearly a half-century of public-health gains have been wiped away.)
Many things allow militant Islam to take root and grow; eliminating AIDS would certainly not eliminate jihadism. Still, a pandemic, in addition to being a human tragedy, makes governments unstable and regions ungovernable. And as one report put it, “Unstable and ungoverned regions of the world … pose dangers for neighbors and can become the setting for broader problems of terrorism … The impoverished regions of the world can be unstable, volatile, and dangerous and can represent great threats to America, Europe, and the world. We must work with the people of these regions to promote sustainable economic growth, better health, good governance and greater human security. …”
One might think that this observation very nearly qualifies as banal — but for Derbyshire, it qualifies as a revelation.
For the sake of the argument, though, let’s assume that the American government acts not out of a narrow interpretation of the national interest but instead out of benevolence — like, say, America’s response to the 2004 tsunami that hit Indonesia and other nations in the Indian Ocean. Why is that something we should oppose, or find alarming, or deem un-conservative? The impulse to act is, in fact, not only deeply humane but also deeply American.
In a speech in Lewiston, Illinois, in 1858, Abraham Lincoln, in quoting from the Declaration (“all men are created equal … endowed by their Creator with certain unalienable right”), said:
This was their majestic interpretation of the economy of the Universe. This was their lofty, and wise, and noble understanding of the justice of the Creator to His creatures. Yes, gentlemen, to all His creatures, to the whole great family of man. In their enlightened belief, nothing stamped with the Divine image and likeness was sent into the world to be trodden on, and degraded, and imbruted by its fellows.
This belief about inherent human dignity does not mean that America can solve every problem in the world or that we shouldn’t focus most of our energy and treasure on America itself. But if the United States is able, at a reasonable cost ($25 billion over five years), to help prevent widespread death, that is something we should be proud of it. (A recent Stanford study found that PEPFAR was responsible for saving the lives of more than a million Africans in just its first three years.)
Derbyshire seems to take an almost childish delight in advertising his indifference to the suffering of others, at least when the others live on a different continent and come from a different culture. Back in February 2006, when more than 1,000 people were believed to have died when an Egyptian ferry sank in the Red Sea, Derbyshire wrote:
In between our last two posts I went to Drudge to see what was happening in the world. The lead story was about a ship disaster in the Red Sea. From the headline picture, it looked like a cruise ship. I therefore assumed that some people very much like the Americans I went cruising with last year were the victims. I went to the news story. A couple of sentences in, I learned that the ship was in fact a ferry, the victims all Egyptians. I lost interest at once, and stopped reading. I don’t care about Egyptians.
Cultivating what Adam Smith (in The Theory of Moral Sentiments) called “sympathy” and “fellow feeling” is a complicated matter. Suffice it to say that very few of us care about the suffering and fate of others as much as we should. Yet most of us aren’t proud of this fact; we are, rather, slightly embarrassed by it. Not John Derbyshire. He seems eager to celebrate his callousness, as if it were a sign of manliness and tough-mindedness. I haven’t a clue whether this is a pose, done for shock value or some such thing, or real. All we can do is judge Derbyshire by his public words. And they are not only unpersuasive; they are at times downright ugly.