Lifeline: The Story of PEPFAR, the Greatest Humanitarian Initiative of Our Time

An inspiring account of how the US government built a start-up development program to fight AIDS called PEPFAR, which saved more than twenty-six million lives and created a new blueprint for results-oriented American foreign aid.

In 2002, more than two million Africans died of AIDS. Militaries reported HIV infection rates of more than twenty-five percent. Nearly four in ten pregnant women in some countries were infected. But in 2003, to the surprise of the world, President George W. Bush created PEPFAR, the President's Emergency Plan for AIDS Relief, which became his signature legacy for doing good in his eight years in office. PEPFAR has saved more than twenty-six million lives, prevented HIV from being transmitted to nearly eight million infants during birth, stabilized governments, and built back economies in Africa. It has been arguably America’s most successful foreign assistance program in history.

How did it succeed? Lifeline tells the remarkable fast-paced story of how a small core of Americans and Africans built AIDS treatment programs from scratch in many countries—and how they faced down people who tried to stop them with grit and ingenuity. Based on interviews with more than 200 people—from President Bush and Dr. Anthony Fauci to local physicians and patients in small villages across Africa—Lifeline demonstrates indisputably the essence of American leadership and how America has, and still can, tackle the world’s greatest challenges and be a force for good in the world.

"John Donnelly has told one of the great untold stories of the century. Admirers of George W. Bush will be pleased. Detractors of George W. Bush will be astonished—and will never think of him the same way again." — David Shribman, Pulitzer-Winning Executive Editor Emeritus of the Pittsburgh Post-Gazette

“There was a time, not long ago, when a group of imperfect leaders faced a global tragedy and chose to do the right thing. Lifeline tends the embers of that spirit.” — Helen Epstein, author of The Invisible Cure: Africa, the West, and the Fight Against AIDS

“A masterful yet uplifting chronicle that merges Washington politics with the horrors of AIDS in Africa. It should be required reading for politicians and diplomats.” — Max Essex, Lasker Professor Emeritus, Harvard University

“One of the most consequential—yet neglected—stories of the early 21st century is the American-led effort to check the ravages of HIV/AIDS in Africa, which saved perhaps 26 million people from premature and miserable deaths. In Lifeline, John Donnelly tells this medical, political, and above all, human story with verve and pace, taking readers inside the sleek corridors of power in Washington and the bleak hospital wards of Malawi, Uganda, and South Africa. Everyone in, or thinking of entering, the public health field should read this book.” — J.R. McNeill, Georgetown University, author of Something New Under the Sun

“John Donnelly captures the bold leadership and determination that made PEPFAR a reality, and transformed diplomacy to hope and resilience. The book is a powerful account of how Kenya and many African countries confronted the HIV crisis through partnerships, innovation and lots of courage.” — Dr. Doris K. Macharia, President of the Elizabeth Glaser Pediatric AIDS Foundation