The President's Emergency Program for AIDS Relief (PEPFAR) was arguably President George W' Bush's single greatest achievement. Thanks to American leadership and over $50 billion in U.S. funding committed since President Bush launched the initiative in 2003, millions of lives have been saved and millions more HIV/AIDS cases prevented in 15 African countries targeted for international action. During his July 2013 trip to Africa, President Obama rightly called PEPFAR one Bush's "crowning achievements" and used their joint 2013 visit to Tanzania to "thank him on behalf of the American people for showing how American generosity and foresight could end up making a real difference in people's lives." As Bill Clinton put it in 2012:

"I have to be grateful, and you should be too, that President George W. Bush supported PEPFAR. It saved the lives of millions of people in poor countries."

That's why it's once again time for the United States to step up with a new multi-year, multi-billion dollar commitment, this time against Ebola. With over 4,500 already dead and tens of thousands more at risk in Guinea, Liberia and Sierra Leone, it's not simply (as Bill Clinton is so fond of saying) "the right thing to do. In this case, charity does not begin at home: Americans' health and safety requires America to go all in--in Africa.

While the U.S. media fuel panic over the one fatality and handful of Ebola cases here, the need for urgent, global mobilization to save West Africa cannot be overstated. As CNN reported on Friday:

Liberia, meanwhile, which is hardest hit by the virus, says it requires 2.4 million boxes of protective gloves -- and 85,000 body bags, to be able to fight the virus in the next six months. Currently, it only has 18,000 boxes of gloves and less than 5,000 body bags.
Let that second number sink in.
Eight-five thousand body bags needed.[Emphasis original.]

As Liberian President Ellen Sirleaf Johnson put it bluntly in her plea for international action, the Ebola virus "respects no borders."

"We all have a stake in the battle against Ebola. It is the duty of all of us, as global citizens, to send a message that we will not leave millions of West Africans to fend for themselves."

And the United States has only begun to fight.

So far, Congress has approved $750 million in Pentagon spending to be redirected to President Obama's relief mission. The U.S. has also pledged over $200 million to a United Nations fund hoping to raise $988 million. But the resources will be only a fraction of what will be needed not only to combat the current Ebola outbreak, but to fight and prevent future epidemics. African economies devastated by Ebola and the wholly inadequate public health infrastructures in most will require global aid and partnerships for years to come.
That's why President Obama should announce the President's Emergency Program for Ebola Relief (PEPFER), committing $25 billion over the next five years. Those dollars will build hundreds of clinics, buy thousands of ambulances, create stockpiles of protective gear, fund the deployment of hundreds of doctors, nurses, technicians and other public health professionals. New "clean" room emergency facilities should be rolled out in the U.S., in Europe and in sub-Saharan Africa to handle individual cases in order to head off future contagions. Critically, PEPFER should invest in new treatments and vaccines for Ebola. And the global program should help set up "trust funds" for African governments to ensure future "recurring" funding for doctors and nurses as well as maintenance for hospitals, clinics and equipment. (As I learned first hand in The Gambia in the late 1980's, the "recurrent cost problem" after initial foreign aid dries up is one of the great pitfalls on international assistance to developing economies.)
Despite the current epidemic of conservative political opportunism, Barack Obama should be able to demand bipartisan support for the President's Emergency Program for Ebola Relief. Americans in general and Republicans in particular may hate foreign aid, but they hate Ebola even more. And there can be no question of how to come up with $25 billion over five years. After all, President Bush and his GOP allies never required new taxes or spending cuts as a "pay for" for PEPFAR. And as the CBO recently reported, the federal budget deficit for FY 2014 didn't just decline to its lowest level since 2007; it was $20 billion than the nonpartisan budget agency forecast in August.

So, the United States can definitely afford the President's Emergency Program for Ebola Relief. As the horrifying body count in Africa and the disturbing demagoguery here show, America can't afford to not do PEPFER. As President Bush told the nation when he unveiled his historic campaign against HIV/AIDS during the 2003 State of the Union Address:

Ladies and gentlemen, seldom has history offered a greater opportunity to do so much for so many. We have confronted, and will continue to confront, HIV/AIDS in our own country. And to meet a severe and urgent crisis abroad, tonight I propose the Emergency Plan for AIDS Relief, a work of mercy beyond all current international efforts to help the people of Africa.

As Monica Nyawo, a counselor at an AIDS clinic near Durban who is HIV positive put it in June 2013, "I am alive because of the ARVs [anti-retroviral drugs]I received through the PEPFAR funding." And as President Obama declared of countless others like her:

"President Bush deserves enormous credit for that. It is really important. And it saved lives of millions of people."

It's now time for the United States to take action on a grand scale against Ebola. It's not just enlightened self-interest to protect Americans here at home. With so many at risk in Africa, it's simply the right thing to do.