The Guardian examines the reflections of former President George W. Bush on “the $15bn President’s Emergency Plan for Aids Relief (PEPFAR) which distributed antiretroviral drugs to keep people with HIV alive,” as the president describes in his recently released memoir, Decision Points.

In the book, Bush describes his motivation for PEPFAR, writing, “I decided to make confronting the scourge of AIDS in Africa a key element of my foreign policy,” according to the Guardian. “But he would avoid the U.N. as ‘too cumbersome and inefficient,'” the newspaper adds.

“I couldn’t stand the idea of innocent people dying while the international community delayed,” Bush writes in the memoir, according to the Guardian. “I decided it was time for America to launch a global AIDS initiative of our own. We would control the funds. We would move fast. And we would insist on results,” he writes. In his book, “Bush says he wanted to rethink how aid was delivered to get away from what he regarded as traditional paternalism of development aid.”

“At the time it was estimated that 4 million people in Africa were HIV-positive but fewer than 50,000 were receiving antiretroviral drugs. By the end of Bush’s presidency, about 2 million people were receiving the medicines via his initiative,” the Guardian writes. The former president also writes of the importance of PEPFAR programs “‘caring for victims of AIDS, especially orphans. It broke my heart 14 million children had lost parents to AIDS. It also worried me. A generation of rootless, desperate young people would be vulnerable to recruitment by extremists.'” The article notes that Bush’s memoir responds to some who questioned his reasoning for creating the program (McGreal, 11/8).