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A Response to Peter Wehner on PEPFAR



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Kathryn:  I’m going to pass very lightly over the fact, noted by several emailers, that the two persons whose responses to my anti-PEPFAR posts (Dec. 1 and Dec. 2) you have chosen to publish bear the names Putze and Wehner. Possibly you are signaling something … but as I said, I prefer to pass over this without further comment.

Now to Peter Wehner’s Commentary blog post:

First, those “few facts that undermine Derbyshire’s case.”

•  “Africans have fewer sex partners on average over a lifetime than do Americans.” I never wrote anything to the contrary. I wrote in general terms of “customary practices.” Mr. Wehner’s statistic, even if true (he offers no links or references), therefore does nothing to undermine my case.

So far as I understand the epidemiology literature, the most relevant of those customary practices is concurrency, i.e. having two or more steady sex partners at the same time. There is a cursory survey here, with some useful links.  Sample quote:

Researcher Martina Morris … later teams up with the mathematician Mirjam Kretzschmar to develop a new model that could compare the spread of HIV through two hypothetical populations: one in which concurrent partnerships were common and another in which serial monogamy was the norm. They found that HIV spread 10 times faster in the first population.

•  “22 countries in Africa have had a greater than 25 percent decline in infections in the past 10 years.” Possibly so: but does this have anything to do with PEPFAR, which is the subject under discussion? Let’s take a look.

UNAIDS offers some very handy interactive web pages where you can summon up all the relevant statistics. (Sample such page here.) I just went through the pages for the current PEPFAR focus countries, graphing “Number of new infections — all ages.” There was no data for Ethiopia. For the other 13, here is the year in which the graph last turned down (alphabetic order by country, Botswana to Zambia):  1997, 1994, 1990, 1994, 1994, 2003, 2000, 2003, 1999, 1993, 1991, 2001, 2005.

PEPFAR was authorized in 2003. The first field programs got under way in mid-2004.

[I note that (a) this is a rather good illustration of Charles Murray's Trendline Test, and (b) the leveling-off you see in most of those graphs across the past few years might be taken as support for my case that, once the drugs were available, people resumed doing what they had customarily done. You'd need a deeper data analysis to clinch the argument; but at the very least, we are a long way from "facts that undermine Derbyshire's case."]

•  “America’s efforts are helping to create a remarkable shift in how, in Africa, boys view girls — reflected in a decline of more than 50 percent in sexual partners among boys.” Unfortunately the UNAIDS charts are nothing like as clear on this and I can locate no other data source. No doubt Mr. Wehner can provide one, including of course evidence that the increasing restraint among African “boys” (?) is driven in part by PEPFARS.

Then there are some impertinent speculations concerning what I do and do not care about. I shall surrender here to the temptation that always comes over me when I am the target of sanctimonious bullying by self-congratulating prigs:  Bite me, pal.

Next Mr. Wehner tells me that I am “more than a decade behind in [my] understanding of overseas-development policy.” He tells us how “transformational” President Bush’s development effort was. He throws in another sneer: “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.”

Certainly I am no expert. I did, though, in March 2008 write a longish researched piece on aid to Africa for The American Conservative. (A magazine which, I venture to suspect, never sullied the desktops of the George W. Bush White House. The title alone would have disqualified it.) For background I read with careful attention two books recommended to me by friends knowledgeable in the field, and skim-read half a dozen more, as well as doing the usual internet trawling and attending a lecture.

I can tell Mr. Wehner with strong confidence that if he thinks President Bush transformed the foreign-aid scene from a less-effective to a more-effective model, he is in a world-wide minority of one two.

What we in fact see when surveying the history of foreign aid is an elephants’ graveyard of “transformational” magic cures — Community Development! SALs! SPA! Millennium Challenge Accounts! — each of which glowed bright for a while, then faded away in disappointment, corruption, book-cooking, and bureaucratic face-saving.

(In this, foreign aid strongly resembles education policy — SEED! KIPP! Charter Schools! — where GWB also left his moon-booted footprints.)

The picture drawn by Mr. Wehner, that foreign aid was languishing in a no-strings doldrums until — the reader should imagine some soaring orchestral music here — George W. Bush came along and “transformed” it, is a ludicrous misrepresentation. I should very much like to see him try it out in the presence of someone who is actually acquainted with the history of foreign aid — William Easterley, for example.

There is then some argument that PEPFAR helps promote orderliness in poor nations. On this, I don’t have anything to add to what I said in my December 2 post. Mr. Wehner’s remarks are anyway just a chain of unjustified, unreferenced assertions. Some of them are contradicted by the much more knowledgeable Princeton N. Lyman and Stephen B. Wittels in the Foreign Affairs paper that was the hinge of my original post.

Mr. Wehner has nothing to say about that paper. If he has read it he will know how spurious is his comparison of PEPFAR — an ever-increasing permanent welfare commitment — to the 2004 tsunami relief effort, a one-off rescue mission.

I will yield to the collective wisdom of the U.S. electorate on what humanitarian calamities we should or should not spend public money to relieve; but I’d bet that while a healthy majority of Americans favor one-off disaster relief efforts in remote places, far fewer would, if told honestly about it, support an everlasting, ever-swelling commitment to provide expensive medications to people in inconsequential countries for the alleviation of a venereal disease.

Along the way there somewhere Mr. Wehner quotes Abraham Lincoln at me. Why? While I am sure Lincoln approved of private missionary efforts to improve lives in Asia, Europe, Africa, Oceania, and Latin America, I have never heard that he asked Congress to appropriate funds for such works.

The rest is just more low ad hominem sneering. Goodness, how the man does sneer! He says that I am “eager to celebrate [my] callousness,” and quotes in support something I wrote in early 2006. Since I write roughly a hundred thousand words of fugitive journalism a year, that is around half a million words ago. I don’t see much “eagerness” there. If I were to mention, say, Brussels sprouts once every five years, would Mr. Wehner accuse me of being obsessed with that vegetable? Probably he would, if he could deploy the accusation in such a way as to demonstrate his own moral superiority over citizens so busy working for a living, caring for their families and friends, and worrying about the condition of their country that they have nothing to spare for the misfortunes of people in remote, unimportant places.

Such an approach to the affairs of the world is, says Mr. Wehner, falling very naturally into the cant vocabulary of liberal condescension, “ugly.” Well, well; perhaps ugliness, like beauty, is in the eye of the beholder.

Charity begins at home, Mr. Wehner. If not exactly noble — certainly it is at an infinite distance below the nobility and, ah, beauty of your own lofty concerns — the indifference that I am so “eager to celebrate” once or twice a decade is at least less harmful to my own family and nation than the universalism of Mrs. Jellyby in Bleak House, whose attentions to the natives of Borrioboola-Gha (“on the left bank of the Niger”) left her no time to spare for her own kin. Says the narrator:

It struck me that if Mrs. Jellyby had discharged her own natural duties and obligations before she swept the horizon with a telescope in search of others, she would have taken the best precautions against becoming absurd …

At least Mrs. Jellyby’s enterprises did not draw on public funds. But as George Orwell observed: “A humanitarian is always a hypocrite.”



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