Decision Points

wide range of lawmakers, from conservatives like Jesse Helms of North Carolina to liberals like Joe Biden of Delaware and John Kerry of Massachusetts. I told Bill I hoped to sign a bill before I left for the 2003 G-8 summit in Evian, France, so that I would have more leverage to persuade our allies to join us. Bill worked tirelessly to meet the deadline. Three days before I left the country, I signed PEPFAR into law.

    Two months later, Laura and I touched down in sub-Saharan Africa. Our first stop was Senegal . After a morning meeting at the presidential palace, President Abdoulaye Wade and his wife, Viviane, escorted us to one of the most haunting places I visited as president, Gorée Island.

    Standing at the threshold of the Door of No Return on Gorée Island.
White House/Eric Draper
    Our tour began in a pink stucco structure, the Slave House. The museum curator showed Laura and me through the small, hot rooms. One had contained scales to weigh the slaves. Another was divided into cells to separate men, women, and children. We walked through a narrow passageway to the Door of No Return, the starting point for the horrific Middle Passage. I could only imagine the fear of those hopeless souls who were stolen from their families and shoved onto ships bound for an unfamiliar land. I put my arm around Laura as we peered out at the blue ocean.
    Standing behind us were Colin Powell and Condi Rice. I thoughtabout the contrast between what their ancestors had endured and what Colin and Condi had accomplished. After the tour, I gave a speech from the island:
    At this place, liberty and life were stolen and sold. Human beings were delivered and sorted, and weighed, and branded with the marks of commercial enterprises, and loaded as cargo on a voyage without return. One of the largest migrations of history was also one of the greatest crimes of history. …
    For two hundred fifty years the captives endured an assault on their culture and their dignity. The spirit of Africans in America did not break. Yet the spirit of their captors was corrupted. … A republic founded on equality for all became a prison for millions. And yet in the words of the African proverb, “No fist is big enough to hide the sky.” All the generations of oppression under the laws of man could not crush the hope of freedom and defeat the purposes of God. …
    In the struggle of the centuries, America learned that freedom is not the possession of one race. We know with equal certainty that freedom is not the possession of one nation. This belief in the natural rights of man, this conviction that justice should reach wherever the sun passes, leads America into the world. With the power and resources given to us, the United States seeks to bring peace where there is conflict, hope where there is suffering, and liberty where there is tyranny.
    PEPFAR was a new chapter in Africa’s unfolding story of freedom, dignity, and hope. In every country I visited, I promised that America would meet our commitments. In South Africa , where nearly five million lived with HIV, I urged a reluctant President Thabo Mbeki to confront the disease openly and directly. In Botswana , a relatively wealthy country where 38 percent of the adult population was infected, President Festus Mogae pledged to use PEPFAR funds to continue the impressive effort he had begun to fight the disease. At the national hospital in Abuja, Nigeria, I visited with women who had benefited from the mother and child initiative. They beamed with joy as they showed me their healthy children. But for every infant born infection-free, many more began life facing the burden of HIV.
    The most memorable part of the trip was our visit to the TASO clinic in Uganda , where I met Mohamad Kalyesubula . Escorted by President Yoweri Museveni and his wife Janet, Laura and I went around the room and hugged the patients. Many opened up to us. They shared their hopes and fears. One nurse named Agnes told me her husband had died of AIDS in 1992. When she got tested, she found out that she, too, had HIV. She was one of the lucky few who had been able to get antiretroviral drugs. She urged me to send more medicine, as soon as possible. When the drugs supported by PEPFAR reached Uganda, Agnes helped nurse many of TASO’s patients back to health. One was Mohamad. When he came to the White House in 2008, Agnes came too.
    The director of TASO, a doctor named Alex Coutinho , later said I was the first world leader he had