An editorial in today’s New York Times talked about Mr. Bush’s Health Care Legacy. An important piece of this legacy, and one that has been discussed frequently on this blog, as well as hotly debated in the health world is President Bush’s most recent reauthorization of the President’s Emergency Plan for AIDS Relief (PEPFAR). This important piece of legislation will renew the original PEPFAR for the next five years to fight global AIDS, malaria and tuberculosis, and increase the funding for it to $48 billion.

While many criticize the Bush administration for it’s dismal handling of many other health issues, the reauthorization of PEPFAR stands out as a significant achievement in the global fight against HIV/AIDS, and one that could not have been done without President Bush’s support and consistent work on this issue.

However one must also wonder what spurred the original creation of PEPFAR in 2003 and then reauthorization by President Bush, especially with an increasingly severe economic crisis at hand, America’s steady fall from being a great power, and the continuous difficulties the US faces with war, oil dependence, job loss and more.

Maybe we should be looking at the possibility of how PEPFAR has been used as a political maneuver to make the US look better in the eyes of the rest of the world. With little else to show for in the past 8 years, this could be viewed as a way for President Bush to use this as the exemplar for how good the US is about providing foreign assistance, which maybe will make other countries cast a slightly less disapproving eye towards to US.

Either way, PEPFAR certainly will stand out in the Bush administration as a shining jewel amidst a whole lot of bad policy and governance muck.