Chapter focus: Hein examines how bold U.S. global health initiatives, faith-based partnerships, and market-oriented development strategies sought to move Africa from crisis and dependency toward health, opportunity, and self-reliance.

Think Big

• President George W. Bush responded to the scale of Africa’s HIV/AIDS crisis by challenging his administration to “think big,” moving beyond incremental assistance toward an unprecedented, measurable global health strategy.
• PEPFAR committed $15 billion to prevent infections, treat people living with AIDS, and strengthen health systems, demonstrating that compassion could be paired with clear goals, performance measures, and accountability.
• The chapter presents this as a defining example of compassionate conservatism: a willingness to respond to suffering while demanding results from those entrusted with public resources.

An Unlikely Alliance

• PEPFAR emerged from an unusual coalition of political, cultural, and faith leaders, including President Bush, Senator Jesse Helms, Bono, and Franklin Graham, who shared a conviction that the AIDS crisis could not be ignored.
• Faith was central not only to motivation but also to implementation. African faith-based and community organizations were trusted partners with deep local reach; more than 80 percent of PEPFAR grantees were African faith-based and community organizations.
• The initiative also demonstrated the power of bipartisan leadership, with Republicans and Democrats joining together to advance an ambitious response to the epidemic.

Putting Ideas into Action

• Implementing PEPFAR required a different kind of leadership. Bush selected former Eli Lilly CEO Randall Tobias to manage the complexity of the initiative and advance a model based on partnership rather than paternalism.
• Health interventions had to address the realities surrounding disease, especially hunger. The chapter highlights the integration of food, medicine, agriculture, and local capacity as essential to effective treatment.
• Indiana connections were important to this work, including Tobias and the Indiana University AIDS program in Kenya, which linked AIDS treatment with nutrition and agricultural production.

Ending Malaria

• The President’s Malaria Initiative (PMI) brought the same ambitious, partnership-driven approach to another major African health crisis, committing $1.2 billion to fight malaria in 15 of the hardest-hit African nations.
• Government, faith-based organizations, and corporations worked together on spraying, bed nets, medicines, training, and public awareness. The chapter points to major reductions in malaria infection and mortality as evidence of what coordinated action can accomplish.
• Admiral Timothy Ziemer’s story illustrates the deeply personal commitment behind the effort and the role of faith-based networks in mobilizing practical action against global health challenges.

Relief Is Not Development

• Hein distinguishes humanitarian relief from sustainable development: saving lives is essential, but poverty ultimately requires self-generating economic solutions, local capacity, and opportunity.
• The Millennium Challenge Corporation (MCC) tied development assistance to performance in three areas: governing justly, investing in people, and promoting economic freedom. The model emphasized accountability, local ownership, and incentives for reform.
• The chapter argues that private philanthropy and remittances are also powerful forces for development, often exceeding government-to-government aid and offering opportunities to strengthen communities through investment rather than dependency.

Faith in Rwanda

• Rwanda is presented as a case study of how a nation can move from devastating crisis toward economic and institutional renewal through capable leadership, entrepreneurship, and strategic partnerships.
• President Paul Kagame sought to attract investment and build institutions, while American business and faith leaders contributed expertise, capital, networks, and entrepreneurial capacity.
• Rick Warren’s network and other partners helped connect faith, business, education, health, and economic development, illustrating how international partners can support locally defined priorities.

Seeking a Triple Bottom Line

• Joe Ritchie, Bishop John Rucyahana, Dale Dawson, and Scott Ford exemplify a model of social entrepreneurship that pursues three outcomes at once: financial sustainability, Rwandan development, and spiritual growth.
• Examples include expanding access to banking and microenterprise capital, strengthening education, developing businesses, and building Rwanda’s coffee industry.
• These efforts demonstrate that investment in people can be both socially beneficial and economically sound, creating businesses that strengthen local communities while generating returns.

Partnership, Not Paternalism

• The chapter’s central lesson is that development works best when local leaders define priorities and outside partners bring resources, expertise, networks, and capital to support them.
• Government, business, faith communities, and civil society can operate as co-equal partners rather than treating Africa as a passive recipient of aid.
• Ultimately, the goal is human flourishing: education, capital investment, jobs, health, and the opportunity for African communities to shape and sustain their own future.