And then there were these sentences in the 2003 address 10 years ago: “Tonight I propose the Emergency Plan for AIDS Relief,” said President George W. Bush, “a work of mercy beyond all current international efforts to help the people of Africa. This comprehensive plan will prevent 7 million new AIDS infections, treat at least 2 million people with life-extending drugs and provide humane care for millions of people suffering from AIDS and for children orphaned by AIDS.” …

In retrospect, the words were not particularly memorable. But the moment was remarkable. An initiative of this scale and ambition — the largest effort to fight a single disease in history — was utterly unexpected. Bush’s strongest political supporters had not demanded it. His strongest critics, at least for a time, remained suspicious. The President’s Emergency Plan for AIDS Relief (PEPFAR) existed entirely because of a willing leader, a creative policy team, a smattering of activists and a vast, bleeding need. …

PEPFAR offers some political philosophic lessons. Liberals had to get accustomed to measured outcomes and accountability. Conservatives had to abandon an indiscriminate cynicism about the capabilities of the state. I remember once citing PEPFAR’s achievements to a conservative leader as one example of successful governmental action. He responded dismissively, “But other than that?” Other than saving a few million lives on a distant continent from a cold start in less than a decade?