John Donnelly
Lifeline: The Story of PEPFAR, the Greatest Humanitarian Initiative of Our Time
(Harper, October 2026)
An inspiring account of how the US government built a start-up development program to fight AIDS called PEPFAR, which saved more than twenty-six million lives and created a new blueprint for results-oriented American foreign aid.
In 2002, more than two million Africans died of AIDS. Militaries reported HIV infection rates of more than twenty-five percent. Nearly four in ten pregnant women in some countries were infected. But in 2003, to the surprise of the world, President George W. Bush created PEPFAR, the President’s Emergency Plan for AIDS Relief, which became his signature legacy for doing good in his eight years in office. PEPFAR has saved more than twenty-six million lives, prevented HIV from being transmitted to nearly eight million infants during birth, stabilized governments, and built back economies in Africa. It has been arguably America’s most successful foreign assistance program in history.
How did it succeed? Lifeline tells the remarkable fast-paced story of how a small core of Americans and Africans built AIDS treatment programs from scratch in many countries—and how they faced down people who tried to stop them with grit and ingenuity. Based on interviews with more than 200 people—from President Bush and Dr. Anthony Fauci to local physicians and patients in small villages across Africa—Lifeline demonstrates indisputably the essence of American leadership and how America has, and still can, tackle the world’s greatest challenges and be a force for good in the world.
Praise for Lifeline
“This book is not just history; Lifeline is a roadmap and a reminder of what is possible when evidence, empathy, and sustained global commitment align.” — Dr. Sanjay Gupta
“John Donnelly has brilliantly captured the challenges and at times heroic efforts to establish PEPFAR. Reading the book, one feels immersed in the program’s creation and early success. His story illustrates how the US government can save millions of lives around the world and is a wise lesson for our future.” — Michael Merson, former director of the World Health Organization Global Program on AIDS and professor emeritus, Duke University Global Health Institute
“Lifeline tells the riveting story of the greatest humanitarian undertaking in global history. It saved more than 26 million lives as well as many struggling democracies, altering the fate of the African continent. John Donnelly’s gripping saga, teeming with colorful characters, tells of a high-octane race to control the AIDS pandemic. Lifeline is a must read — and a handbook for how to handle the next major global emergency.” — Sally H. Jacobs, author of Althea: The Life of Tennis Champion Althea Gibson
John Donnelly spent more than a decade covering the politics of AIDS and America’s response to the pandemic for The Boston Globe. He lived for several years in South Africa and traveled the continent of Africa for The Globe immediately following PEPFAR’s launch. After his career in journalism, he became an adviser to the President of the World Bank and received a Bellagio residency from the Rockefeller Foundation to write this book. He lives in Chevy Chase, Maryland.