Blood is tested in a TOGA container converted into a laboratory at the AIDS Care Training and Support Initiative at White River Junction, South Africa. The center, partly funded by the President’s Emergency Plan for AIDS Relief (PEPFAR) supports the development of a community-based palliative care unit which provides care, education and training for staff and community caregivers, volunteer counseling and testing facilities. (The Minnesota Star Tribune)

The Affordable Care Act enabled millions of Americans get health insurance under former President Barack Obama. What too few people realize is that former President George W. Bush's legacy also includes expanding access to lifesaving medical care to millions of people — those who are infected with the AIDS virus in some of the world's poorest countries.

The Bush program, known as the President's Emergency Plan for AIDS Relief, or PEPFAR, is one of the most significant humanitarian initiatives in our nation's history. "America's commitment to fighting the global AIDS epidemic" is how the U.S. State Department sums it up. Since its 2003 launch, PEPFAR has thwarted this terrible disease by providing modern drugs to treat those infected with it. The 2016 cost for its "bilateral AIDS/HIV programs"that fund regional treatment, research and prevention: $5.2 billion.

Regrettably, PEPFAR is now in the budget cross hairs of the young Trump administration. The president's so-called "skinny budget" proposal for 2017 recommends dramatic cuts to medical research, health and human services programs and the State Department, among other areas. While many observers initially thought the administration had spared PEPFAR, closer scrutiny of its "reduction options" reveals a recommended cut of at least $242 million.

The PEPFAR reductions have not been enacted because Congress has yet to pass a 2017 budget. But PEPFAR's inclusion in the administration's "reduction options" suggests a potential retreat from the nation's role in leading the global fight against AIDS. That's deeply troubling.

PEPFAR works and is a smart, targeted use of public dollars to keep under control a much-feared disease proven to cross borders with ease. The Bush program has played a vital role in reducing the prevalence of HIV infection by double digits in the African nations of Zimbabwe, Malawi and Zambia. In 2016, it provided lifesaving antiretroviral drugs to around 11.5 million people. Just 50,000 people in sub-Saharan Africa, the AIDS epidemic's epicenter, were taking these drugs in 2003.

PEPFAR also provides care and support to roughly 6.2 million children affected or orphaned by the AIDS epidemic. In addition, PEPFAR made it possible for "nearly 2 million babies to be born HIV-free to pregnant women living with HIV — almost twice as many as in 2013 — and their mothers have been kept healthy and alive to protect and nurture them.''

Former President Bush has kept a low profile since leaving office in 2008. But he recently wrote a commentary for the Washington Post urging Congress to fully fund the program. The 2017 funding request for PEPFAR HIV/AIDS programs: $5.2 billion. Bush's defense of this remarkable humanitarian program is welcome. He's exactly right in saying that: "We are on the verge of an AIDS-free generation, but the people of Africa still need our help."

Americans should take the former president's advice and "keep going until the job is done."