An inspiring account of how the US government built a start-up called PEPFAR to fight AIDS—and saved more than 26 million lives.

In the early 2000s, rich governments did little to fight a raging AIDS pandemic in Africa. More than two million Africans died of AIDS annually. Several militaries reported HIV infection rates above 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.

Nearly a quarter-century later, the initiative is seen as impactful as the Marshall Plan’s efforts to rebuild Europe after World War II. Lifeline tells the riveting story of how Americans and Africans raced to set up treatment and prevention programs to save as many lives as possible.

The Boston Sunday Globe front page, January 26, 2003 — 'None of them had to die' — from John Donnelly's reporting on the AIDS pandemic.

The author

John Donnelly spent thirty years as a journalist—much of it covering stories of global health, AIDS, and America’s response to the deadly pandemic. That reporting led to Lifeline.

More about John

Praise for Lifeline

“John Donnelly has told one of the great untold stories of the century. Admirers of George W. Bush will be pleased. Detractors of George W. Bush will be astonished—and will never think of him the same way again.”

David ShribmanPulitzer-winning editor · Pittsburgh Post-Gazette

“A roadmap and a reminder of what is possible when evidence, empathy, and sustained global commitment align.”

Dr. Sanjay GuptaNew York Times bestselling author

“A masterful yet uplifting chronicle. It should be required reading for politicians and diplomats.”

Max EssexLasker Professor Emeritus, Harvard University

“Donnelly has brilliantly captured the heroic efforts to establish PEPFAR—and how the US can save millions of lives.”

Michael MersonFormer Director, WHO Global Program on AIDS

“There was a time, not long ago, when a group of imperfect leaders faced a global tragedy and chose to do the right thing. Lifeline tends the embers of that spirit.”

Helen EpsteinAuthor of The Invisible Cure

“A gripping saga, teeming with colorful characters, of a high-octane race to control the AIDS pandemic—a handbook for how to handle the next major global emergency.”

Sally H. JacobsAuthor of Althea

“A powerful account of how Kenya and many African countries confronted the HIV crisis through partnerships, innovation and lots of courage.”

Dr. Doris MachariaPresident, Elizabeth Glaser Pediatric AIDS Foundation

“Donnelly tells this medical, political, and above all human story with verve and pace. Everyone in the public health field should read this book.”

J. R. McNeillGeorgetown University · author of Something New Under the Sun

On sale October 13, 2026

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