I totally agree with you, but as someone who has seen the impact on the ground in parts of Africa, and how HIV/AIDS is no longer the death sentence it once was, PEPFAR is an amazing program that came too late, but let's not discount the actual good that it has done.
Had they not, PEPFAR or something similar would have existed a decade or more earlier.
Lotsa people died because of that.
By 2003, it was no longer tenable to refuse to fight AIDS, plus, notable GOP family members got AIDS.
Just like Nancy Reagan’s 180 on gay people once her daughter came out.