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    AIDS was not only the leading cause of adult death in many of the places we worked; by the year 2000, it surpassed tuberculosis as the world’s leading infectious killer. As we showed in central Haiti, effective diagnostics and therapeutics for AIDS could be delivered to even the most destitute sick with the help of community health workers. 5 But few seemed interested in funding AIDS care in poor countries. Policy debates pitted prevention against care—as if these were competing priorities rather than complementary ones—and many thought doing both would be too expensive. Partners In Health had been able to finance AIDS treatment in central Haiti because of the generosity of people such as Tom White, a Boston contractor who
had given us millions of dollars over the years. But dependence on angel investors wasn’t going to save millions of lives in Africa, much less integrate prevention and care and strengthen weak health systems. “You need billions, not millions, of dollars,” Jeff Sachs, a development economist and colleague at Harvard, observed. 6
    In December 2000, Sachs and his wife, Sonia, a pediatrician, came to central Haiti to meet some of our AIDS patients, most of whom were flourishing with the help of antiretroviral drugs—the very drugs that many health policy experts argued were too difficult to administer in such poverty-stricken settings. On the spot, Sachs promised to work with the United Nations and several governments to create new funding mechanisms to respond to AIDS, tuberculosis, and malaria, three diseases that by 2001 were claiming six million lives a year. He kept his promise. I was lucky enough to travel to New York with the Haitian delegation, led by another health advocate, First Lady Mildred Aristide, to the first UN general assembly on AIDS. We collectively pushed for new resources to respond to what was then a fairly new and now global threat. A group of Harvard faculty also published a consensus statement arguing that AIDS care and prevention needed to be integrated in the settings hardest hit by the disease. 7
    A year later, with the help of Sachs and many others, including heroic AIDS activists, the Global Fund to Fight AIDS, Tuberculosis, and Malaria was born. One of the Global Fund’s first major grants went towards AIDS programs in Haiti. That same year, a group of physicians lobbied the new U.S. administration to pursue the same agenda, and before long, George W. Bush launched the U.S. President’s Emergency Plan for AIDS Relief. Together, these two programs brought billions of dollars to bear on the neglected diseases of the poor, and saved—no exaggeration—millions of lives. We believed that these disease-specific programs could, if designed properly, be used to strengthen health systems generally, as they had done in central Haiti. 8 Jim Kim left Harvard for the World Health Organization to pursue this vision—bringing better medical services to the world’s bottom billion—on the level of global policy. (Jim later became president of Dartmouth College and was responsible for Dartmouth’s
significant presence in Haiti in the first weeks after the quake.)
    It was during these years, when I was shuttling between Haiti and Harvard, that President Clinton launched the Clinton Health Access Initiative (CHAI) and became another mentor and colleague. At an AIDS meeting in Barcelona in the summer of 2002, he made plans to come to Haiti and encouraged us to work in Rwanda. “You watch,” he predicted then, “Rwanda will become a model of smart development.” Shortly thereafter, Ira Magaziner, the other driving force behind CHAI, also visited AIDS patients—many of whom had to all intents and purposes risen from the dead after receiving the right treatment—and facilities in central Haiti.
    By 2003, when President Clinton arrived to announce his foundation’s intention to help out in Haiti, we were