Well, we know where at least some of the giant sucking sounds are coming from:

By Eve Conant

Among the Bush administration’s few undisputed successes was its aggressive fight against the global spread of HIV and AIDS. Liberals and conservatives, evangelicals and scientists didn’t agree on much during the last eight years, but they were unified in their enthusiasm for PEPFAR, the President’s Emergency Plan for AIDS Relief, which Congress recently voted to expand into a $48 billion commitment, the largest by any nation, to combat HIV/AIDS, malaria and tuberculosis worldwide. So when PEPFAR’s respected director, Dr. Mark Dybul, was swiftly and surprisingly pushed out of his job the day after President Obama’s inauguration, AIDS activists began to worry that the new administration might fumble the one thing the old group got right.

Let's talk about reality. The reason for praising Bush was simple: this was better than nothing, but it wasn't all that good. Mistaking courtier speak for reality is a good sign of a hack who isn't being straight with readers. Let's look at what people were really saying:

Fix Pepfar:

The President's Emergency Plan for AIDS Relief (PEPFAR) is moving toward a cloture vote in the Senate, a vote that will determine whether the $50 billion reauthorization lives or dies. That same life or death question applies to millions of people in Africa, and comparing actual life or death in Africa to the political legacy of President Bush, as many people see PEPFAR as his greatest achievement, is appalling. Doubly so when the politicians and mainstream media refuse to demand fixes to PEPFAR's problems. Like the rest of President Bush's legacy, PEPFAR, as successful as it has been in part, is a go-it-alone strategy that has alienated much of the rest of the world's public health community.

The reality is this: as successful as PEPFAR has been getting life-saving treatment to nearly two million people, it has failed to slow the infection rate because it has been hampered by unnecessary ideological restrictions. For every two people who receive treatment, five are newly infected with HIV, according to a letter from leading public health advocates circulating on Capitol Hill.

The current legislation will not change that.

At that rate of infection, fiscal conservatives like Sen. Jon Kyl (R-AZ) are right to question the amount of money being spent and if it makes sense, because unless you stem the infection rate, no matter how many people get treated there will always be more than twice as many who don't.

Alienated the global community, failed to slow the infection rate, ideologically restricted. Doesn't sound like "getting it right."

Or what about this description about the reality of pepfar:

Unfortunately, restrictions on prevention funding under the existing law governing PEPFAR have severely hampered efforts to prevent as many new infections as possible and undermined broader efforts to stop the spread of HIV infections. AJWS and a wide range of others are working hard to ensure such restrictions are removed from the new legislation, which if passed will authorize at least $50 billion for AIDS, tuberculosis and malaria from 2008 through 2013. Among our key concerns are to ensure that programs save the greatest number of lives possible through effective and efficient investment of US taxpayer dollars in programs proven to work.

Today, unprotected sex is the single greatest factor in the spread of HIV worldwide and is responsible for more than 80 percent of new infections in sub-Saharan Africa. Comprehensive prevention strategies—including efforts to simultaneously promote delay of sexual initiation among unmarried teens; partner reduction and fidelity; and correct and consistent use of male and female condoms—have proven most effective in reducing the spread of HIV.

Or what about this reply to the LA Times being, shall we say, biased about PEPFAR:

With nary a mention of the multitude of criticisms aimed at the President's Emergency Plan for AIDS Relief, or Pepfar, Edmund Sanders' article, "New life for African AIDS patients," sounds more like a presidential news release than an objective analysis.

The criticisms of Pepfar are numerous. For the first two years of the program, Bush blocked the procurement of most low-cost, generic fixed-dose combinations of antiretrovirals in favor of brand-name, multi-drug regimens that cost twice as much — thus lining the pockets of U.S. pharmaceutical companies instead of saving lives. Even though a generic antiretroviral was approved by the FDA in 2005 and made available for purchase through Pepfar, only 27% of the antiretrovirals purchased by Pepfar in the 2006 fiscal year were generic. In addition, the U.S. has attempted to block access to quality generics on the global market.

Pepfar requires that 33% of all prevention monies (including prevention of nonsexual transmission) and two-thirds of sexual-transmission funds be spent on abstinence and fidelity programs. Many of these programs are administered by "faith-based" organizations, typically evangelical Christian groups that promote "abstinence before marriage" and "being faithful" and downplay the use of condoms. This, combined with the Bush administration's go-it-alone approach and refusal to integrate with national AIDS prevention programs already in place, has essentially destroyed years of AIDS prevention work in several countries. Nowhere is this more apparent than in Uganda, where a highly successful AIDS prevention program that stressed the used of condoms had been in place since 1990. After Uganda accepted Pepfar funding in 2003, faith-based organizations undermined the country's condom program. As a result, millions of condoms sat in warehouses because they were not wanted. According to Dr. Kihumuro Apuuli, the director general of the Uganda AIDS Commission, since it adopted the program, the rate of new HIV infections almost doubled, from 70,000 in 2003 to 130,000 in 2005.

Infection rates doubled under a flat earth style welfare hand out for religious extremists. It's really that simple: Bush's plan kills people. Eve Conant kills people. P

So what was wrong?

How about:

1. Abandon the Ideological Emphasis on Abstinence-Until-Marriage Programming
2. Increase Transparency of PEPFAR Prevention Funds
3. Enact Appropriate Oversight Mechanisms of PEPFAR Prevention Grantees
4. Rescind the Anti-Prostitution Pledge
5. Work with the International Community to Implement Programming and Policy that Connects HIV/AIDS to other Issues of Sexual and Reproductive Health
6. On-the-Ground Monitoring of Funded Activities

Let's go over this: ideological blinders made the program inefficient, the moneys were used to convert people, not stop aids, there was no on the ground monitoring, PEPFAR did not work with other organizations, for reasons which included the "global gag rule." Lastly, because of the anti-prostitution pledge, prostitutes were left out of programs. The very people who spread the disease the fastest, were not given access to services. I am no supporter of prostitution, but pretending it doesn't exist isn't going to make it go away.

PEPFAR didn't get it right, it got it less wrong. People sucking up to a President to save lives isn't an endorsement of the policy in the abstract, it is a sad reality of our corrupt system. And Conant couldn't pass for a journalist in a darkened room, so flagrantly biased and incompetent is her piece. Who hired here? Who keeps her employed? Only some one equally dishonest and inept could keep someone like that on the payroll. But heh, finding people who still like Bush is tough to do.

Dubyl did make a bad program better:

The taint of moral hypocrisy deepened when Randall Tobias, the first head of PEPFAR, who left in 2006, resigned from government a year later after being linked to a prostitution ring. Tobias, a former chief executive of the pharmaceutical company Eli Lilly, had publicly questioned the effectiveness of condoms and the reliability of generic drugs. He was replaced at PEPFAR by Mark Dybul, an intense young doctor who specialized in infectious disease and who had helped to work out the nuts and bolts of the PEPFAR programme with Fauci. Dybul was seen as being more in touch with the reality of AIDS. "As a gay man who lived through the epidemic, he had a professional and personal connection to it in a way that Tobias didn't have," says long-time activist Gregg Gonsalves, now with the International Treatment & Preparedness Coalition in New Haven, Connecticut. "He helped to give [PEPFAR] a more clinical focus and strip it of some of its ideology."

Strip it of "some" of it's ideology. But not all, and not enough. Human decency requires some praise when a man who started an illegal war in Iraq and destroyed the global economy does something less than horrible. PEPFAR has saved some people, we should be thankful it was done at all. But let's not kid ourselves: more people could have been saved if it were not for the ideological rigidity, corruption, and ineptness of a program that sacrificed lives for moralizing on the floor of the US Senate.

How bad was it? According to PEPFAR watch:

Q. So, PEPFAR spends significantly more money on abstinence-until-marriage-only programs than
it does on any other sexual transmission prevention intervention, including ABC?

A. Yes. Of all sexual transmission prevention funding in 2006, PEPFAR spent 56% on abstinence-until-
marriage-only programs. The other 44% was divided among ALL other responses to the sexual transmis-
sion of HIV, including programs that include A, B, and C and programs that target “high-risk groups.”