Good Grief

What do you have to do to get good press ifyou are the Bush Administration. This story reads like an indictment- until you get to the facts:

The Bush administration did not consult with Mozambique last year before designating the country as a beneficiary of its emergency AIDS plan. Mozambique was simply informed that it would be one of 12 African nations, and 15 countries overall, awarded substantial financial assistance.

The pledge of big money was certainly welcome, said Francisco Songane, the Mozambican health minister; AIDS has lowered life expectancy in Mozambique to 38. But the approach, perceived by many Mozambicans as arrogant and neocolonial, was not.

Mozambique, in southeastern Africa, had spent considerable time developing a national strategy to combat its high rate of H.I.V. infection. Other international donors had agreed to pool their contributions and let the Mozambicans control their own health programs. Thus, Mozambican officials recoiled when the Americans said earlier this year, “We want to move quickly, and we know that your government doesn’t have the capacity,” Mr. Songane said.

The Bush administration wanted the bulk of its funding to go toward more costly brand-name antiretroviral drugs for treatment programs run by nongovernmental organizations. But Mozambique had already decided to treat its people with 3-in-1 generic pills, which were cheaper and simpler to take. Also, Mozambique did not want an American program dependent on costly foreign consultants, N.G.O.’s and the largesse of foreign political leaders, that would run parallel to its own.

There were confrontational meetings in Washington and in Maputo, the capital of Mozambique. And in the end, to the surprise of many, the Bush administration agreed to give Mozambique the kind of help it really wanted, by strengthening its laboratories, blood-transfusion centers and the Health Ministry itself – albeit indirectly, through a grant to Columbia University.

“What I witnessed in Mozambique was a disaster averted,” said Dr. Steven Gloyd, an international health specialist at the University of Washington who works with Mozambique. “So, for countries like Mozambique, this may turn out to be a positive intervention, even though it could be a lot more.”

Seventeen months after President Bush announced his five-year, $15 billion emergency AIDS initiative, the program is belatedly getting under way, and surprising some critics of what is seen as its go-it-alone approach. In some cases, the plan is proving to be more adaptive and collaborative than had been expected, especially when countries are strong enough to stand their ground.

Sounds to me like two groups who were not used to working with each other had different ideas until they put their heads together. Instead, this is presented as indictment of the Bush administration’s arrogance.