I recently wrote a rebuttal to ’s case for Trump, arguing that Harris was clearly the better choice. But I left out one important factor: PEPFAR. PEPFAR is among the most important issues for a president to get right, yet is almost entirely ignored by the press—in part because Americans don’t really care about people in other countries. And one of the candidates is clearly better on the subject.
PEPFAR is an international program designed to fight HIV. It’s saved, in total, about 25 million lives since it began under George H.W. Bush (state.gov/results-and-i….), meaning that the number of lives saved by that program outstrips the lives lost in the Iraq war by a factor of ~50. PEPFAR programs run the gamut from preventative programs that spread important information about HIV to ones that provide drugs to treat HIV.
PEPFAR has, since its inception, saved just over a million lives a year—it’s been the most helpful international development program carried out by the U.S.. 20 million people who are alive currently—that’s about one in forty people worldwide—are dependent on medicine from the program. And these numbers underestimate its positive effect, as Saloni Dattani of Vox notes (vox.com/future-perfect/…):
As great as PEPFAR’s impact has been, it is likely underestimated, because it has also helped build health infrastructure and train health care workers across countries as it has grown, supporting treatment for malaria and tuberculosis, which kill 600,000 and 1.3 million people respectively each year.
This is one of the most important government programs to get right. Having never passed PEPFAR would be like causing 50 Iraq wars in terms of lives lost—and that’s a highly conservative estimate. There’s thus an extremely strong reason to vote for the candidate that’s better on PEPFAR.
That candidate is clearly Harris. The Trump budget proposed cutting PEPFAR almost by half. The Republicans have become a party supportive of cutting the PEPFAR program, as indicated by their concerted effort to do so during the Biden administration. One report (s3.amazonaws.com/one.or…) concluded that even just a 20% cut in the program would cost 300,000 lives per year. This seems like a reasonable estimate of the expected difference in PEPFAR spending between Trump and Harris, but even if it’s an overestimate by half, that still means there’s an Iraq war worth of deaths differentiating Trump and Harris, just from their PEPFAR policies.
You might not like a lot of what Harris will do, but it’s hard to imagine most of it killing hundreds of thousands of people. That’s a major point in favor of Harris.